Re: Cholangitis Attack

[Guest guest]

It might be. My first attack came with pain from my lower back such that

I could not get comfortable sitting or lying down. It was hard, sharp,

and totally uncomfortable pain. The doctors, I am sure, will check his

LFT's and this will give them a good indication. If it is Cholangitis

they may put him on a fast for a couple of days to allow his liver to

settle down. They will probably check to see if the Pancreas is evolved.

I know it is miserable, but be patient and they should be able to help

him.

Rob, (Mr. Itch)

PSC 2004, Pancreatitus 2001, Gallbladder remover 2001

Intestinal blockage 2003, Itching since 2001.

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[Guest guest]

It might be. My first attack came with pain from my lower back such that

I could not get comfortable sitting or lying down. It was hard, sharp,

and totally uncomfortable pain. The doctors, I am sure, will check his

LFT's and this will give them a good indication. If it is Cholangitis

they may put him on a fast for a couple of days to allow his liver to

settle down. They will probably check to see if the Pancreas is evolved.

I know it is miserable, but be patient and they should be able to help

him.

Rob, (Mr. Itch)

PSC 2004, Pancreatitus 2001, Gallbladder remover 2001

Intestinal blockage 2003, Itching since 2001.

________________________________________________________________

The best thing to hit the Internet in years - Juno SpeedBand!

Surf the Web up to FIVE TIMES FASTER!

Only $14.95/ month - visit www.juno.com to sign up today!

[Guest guest]

As I mentioned the other day my brother had an attack the other day. At that

time the doctors admitted him and he had an ERCP today. During the ERCP he was

stinted and the doctor placed a “band” around the Portal vein. I know he has

Portal hypertension and that is the reason for the “band” but has anyone else

had this done and what are the potential side effects? Also could anyone give

me some info on portal hypertension.

Thanks again to everyone.

Mark

Sent via Cingular Xpress Mail with Blackberry

[Guest guest]

Hi Mark;

Some links to articles on portal hypertension are as follows:

The Merck Manual - Second Home Edition - Ch. 135. Clinical

Manifestations of Liver. Portal Hypertension

http://www.merck.com/mrkshared/mmanual_home2/sec10/ch135/ch135e.jsp

Portal Hypertension and Bleeding Gastroesophageal Varices

by Guadalupe -Tsao, MD, Best Practice of Medicine.

http://merck.praxis.md/index.asp?page=bpm_brief & article_id=CPM02HP382

Bleeding esophageal varices: How to treat this dreaded complication

of portal hypertension

Ahmed M. Hegab, MD; Velimir A. Luketic, MD

VOL 109 / NO 2 / FEBRUARY 2001 / POSTGRADUATE MEDICINE

http://www.postgradmed.com/issues/2001/02_01/hegab.htm

The latter article includes the following relevant section:

" Endoscopic therapy: Endoscopic sclerotherapy remains first-line

therapy for active variceal bleeding. A sclerosant (eg, morrhuate

sodium [scleromate]) is injected into a varix under direct vision

during endoscopy. This causes tissue edema and mechanical compression

followed by inflammation, variceal thrombosis, fibrosis and, finally,

obliteration. Complications include bleeding ulcers, dysphagia due to

stricture formation, and pleural effusions. Serious but rare problems

are aspiration pneumonia, acute respiratory distress syndrome, and

bowel perforation.

Meta-analysis of six randomized studies proved sclerotherapy to be

more effective than conservative measures (balloon tamponade or

vasopressin therapy) in controlling active bleeding (3). A similar

review of five trials comparing sclerotherapy with octreotide or

somatostatin showed no clear advantage in either bleeding control or

survival rate. The addition of octreotide to sclerotherapy, however,

resulted in significant improvement in early bleeding control in four

of five trials (1,9).

Endoscopic variceal ligation appears to be emerging as a viable

alternative to sclerotherapy, mainly because of fewer complications

and similar efficacy in bleeding control (10). Elastic bands are

placed around varices using a device attached to the end of the

endoscope. Ischemic necrosis, thrombosis, and fibrosis ensue,

eradicating the varix. Concomitant use of octreotide may further

decrease rebleeding rates, but controlled trials are needed to

confirm this. "

Hope this information helps.

I wish your brother a speedy recovery.

Best regards,

Dave